DOA versus Time of Death

[littlefield]

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I've been practicing for 5 years now and have thought of this question often, but a recent event prompts me to ask it here:

Young man, multiple GSW, talking at scene when medics cleared to enter house, but goes into PEA arrest before they can intervene. They start ACLS, bring him to me. PEA, cardiac standstill on ultrasound. I debated whether to call it then, but I had a FM resident with me so we went through the trauma code (chest tube, pericardiocentesis, etc.). Stayed dead.

Would you list this as a DOA or give a "time of death" when efforts stopped? Does the fact that I intervened change your mind? I'm not sure it matters much in the end, but was interested in other's opinions.

Thanks

 

[tdog60tf]

To me a DOA is someone you found dead and did nothing for.

The fact that you "worked" him would lead me to believe you would need to give a TOD.

 

[Tiger26]

To me a DOA is someone you found dead and did nothing for.

The fact that you "worked" him would lead me to believe you would need to give a TOD.

agree

 

[StevieStud]

what I got told a long time ago was that TOD is required if an invasive proceedure or any effort is performed.

(don't know who made the rule or even if really is a rule... but it sounds good)

 

[VienneseWaltz]

You cannot bill for a DOA patient, because as any insurance company will tell you, insurance coverage terminates at the time of a patient's death.

 

[Daiphon]

As I understand it:

DOA = called in field per EMS SMOs.
TOD = your medical decision that they are, in fact, dead.

If they're brought to the ED in a DOA state, then the TOD = when you confirm this.

Cheers!
-d

Sent from my DROID BIONIC using Tapatalk

 

[dotcb]

TOD - when you cease attempts to bring them back